1. Field of the Invention
The present invention relates generally to apparatus and methods for the remote manipulation of surgical needles and other articles. More particularly, the present invention relates to the construction and use of a needle driver which can rotate a curved needle about an axis which is non-coaxial with the axis of the needle driver.
Thoracoscopic, laparoscopic, and other endoscopic surgical procedures are complicated by the need to pass surgical instruments through trocars and other access ports having very small diameters, typically 1 cm or below in diameter. Endoscopic suturing is a particularly time-consuming and tedious process since the ability to "roll" a curved needle through an arc is quite limited. While a variety of endoscopic needle drivers are available, most such needle drivers provide for rotation of the needle through an arc about an axis which is aligned with the axis of the driver itself. Such a configuration makes suturing very difficult in a variety of circumstances.
It would thus be desirable to provide improved apparatus and methods for manipulating surgical needles and other articles in a variety of surgical procedures. It would be particularly desirable to provide improved apparatus and methods for driving curved surgical needles for suturing in thoracoscopic, laparoscopic, and other endoscopic surgical procedures. Such apparatus and methods will preferably provide for rotation of curved surgical needles through an arc about an axis which is oriented at an angle relative to the shaft of the apparatus. Even more preferably, it would be desirable if the apparatus and method provided for holding the needle in a radially offset position relative to the shaft while the needle is being rotated about the angle. The method and instrument should further provide for selective and firm grasping of the needle and for easy and convenient rotation of the needle after it has been grasped. The overall design of the apparatus should facilitate viewing of the needle during both open and endoscopic procedures. It would be still further desirable if the instrument and methods of the present invention were useful for procedures in addition to needle driving and suturing.
2. Description of the Background Art
Needle drivers having jaws disposed on angled or articulated distal ends are disclosed in U.S. Pat. Nos. 5,417,203 and 5,209,747, and Melzer et al. (1994) End. Surg. 2:78-82. Jaw actuation mechanisms for suturing and other laparoscopic procedures are described in U.S. Pat. Nos. 5,281,235; 5,201,743; 5,147,373; 4,580,567; 4,491,135; and 4,165,745. In some cases, the jaw is rotatable about its axis for turning a needle or other purposes. See, for example, U.S. Pat. Nos. 5,147,373 and 4,491,135. Needle drivers having arcuate drive mechanisms are described in U.S. Pat. Nos. 5,391,174; 5,376,096; 5,308,353; 5,224,948; 5,015,250; 4,938,214; 4,621,640; 4,597,390; 4,557,265; and 3,638,654; EP 634 141; and WO 94/28801. Other suturing and needle manipulation devices are described in U.S. Pat. Nos. 5,389,103; 5,306,281; 5,037,433; 4,953,558; and 4,747,358.